THE JOHNS HOPKINS PROJECT REQUEST FORM
Routing and Completion Instructions on last page of Form! Required Data Elements: Field Name is Bolded
SECTION 1 – PROJECT REQUESTOR/ SCOPE:
Requestor:
Tel. No.:
Funded Program Group:
Fax:
Request Date:
Project Manager:
Div/Department /Functional Unit (Applicant) _
Campus Address:
Email:
Requesting Cost Center Number and Name (paying for project):
Project Location/ Bldg.
Floor:
Room(s)
Project Description/Scope/Justification: (Describe in the space below what you would like to have done. Describe the reasons
for the change well as the last changes to this area.)
ESTIMATE ONLY
Schedule: Requested Project Start _________
SECTION 2 - ASSETS
Describe Asset to be purchased:
Finish ________ Relocations required:
Approximate Age of Asset being replaced:
Yes
No
Value of Asset:
Capital Asset:
Yes
Anticipated Date asset is to be in service:
SECTION 3 – FINANCIAL S
Proposed project total cost:
Current $ authority:
Funding: Business Area:
Fund
Number:
No
Amount ($s):
Fund Name:
Business Area:
If more than two funding sources, please add information in this box.
Plant:
Project Type:
JHU 1099
JHHS 2099
Suburban 3099
HCGH 4099
SMH 5099
** Please attach any supporting information, documents, schematics, etc. to this request. **
SECTION 4 - APPROVALS
Signature:
Print Name/Title:
Date:
Signature:
Print Name/Title:
Date:
Signature:
Print Name/Title:
Date:
Signature:
Print Name/Title:
Date:
Signature:
Print Name/Title:
Date:
SECTION – 5 TO BE COMPLETED BY JH FACILITIES/ INFORMATION TECHNOLOGY
Project # / Level 1 WBS # :
Project Name/ Description (limit to 40 characters):
Person Responsible (Project Manager):
Name:
Responsible Cost Center [PM Home CC]:
Confidential:
Updated 10-1-2012
Restricted notification list:
Tel. #.:
Fax:
Email:
ROUTING INSTRUCTIONS:
Department/ Division: Complete all known information. Send completed and approved project request to the JH Facilities
office or Information System Office that will be performing the work.
JH Facilities/ IT, etc.: Review form and content. If requestor has not completed all necessary information, return request.
Send completed forms to faSSC@jhmi.edu for processing.
Contacts:
JH Fixed Assets / Projects Systems Shared Services at the following: fassc@jhmi.edu and
Web: http://ssc.jhmi.edu/fixedassets/index.html
School of Medicine
School of Public Health
Homewood Facilities FD&C
Fax 410-502-1529
Fax 410-502-0062
Email: info.dc@jhu.edu
Bayview Redevelopment Fax 410-550-3068
Bayview IT
Fax 410-550-7148
JHH IT
Fax 410-735-7772
For assistance on how to complete these forms contact your departmental administrator or Business Office.
Please email fassc@jhmi.edu for technical assistance.
Form Completion Instructions/ HELP
Section 1- Requestor
Project / Scope description
Applicant
This section is to help Facilities understand what the project should achieve. Please provide a brief description
of what should be done, as well as the reason for the request. It is important to also note the date of the last
construction / renovation to this area.
The requesting customer by site and by institution
Requesting Cost Center
Cost center requesting the project and funding the expenses.
Requested Start Date
Date the project is scheduled to begin- (please estimate if you are not sure)
Planned Finish Date
Date the project is expected to finish- (please estimate if you are not sure)
Section 2 -Assets
Assets
Section 3 -Financials
Business Area
Plant
Project type
List the BA in which the Department executing the project belongs. Provide Fund Number and Fund Name if
known. If the project is multi-funded, please provide all BAs, Funds Numbers and Fund Names.
1099 - University Service Provider
2099 – Health System Service Provider
For JH HopkinsOne SAP, project types will determine the financial breakdown of projects. “C” projects will be
capital projects that automatically create the Asset under Construction (AuC) designation for settlement while
“E” projects are those that are expensed and settled to expense accounts/cost centers.
The following are available project types:
B1
Library
C1
Safety & Regulatory Compliance
C2
Fleet Repair
C3
Minor Equipment
C4
Major Equipment
C5
Major Construction
C6
Information Systems
C7
Landlord Improvement
CG
Grants
E1
Expense
H1
In house
Section 4-Approvals
Approval Process and Form
Routing
The Administrator of the functional unit/ department must sign all requests.
All SOM projects must have the Director of the SOM Projects sign as well.
Any form not signed by the administrator will not be processed and will be returned.
JHU: <$100,000 (non-capital, no Trustee approval) ;
$100k -$500k (capital, no Trustee approval);
$500k - $2million (capital; no Trustee approval);
$2 million (major capital and Trustee approval)
JHHS: > $50,000 is capital
Section 5 – JH Facilities/ Information Technology
Person Responsible
Project Manager
Responsible cost center
Cost center responsible for carrying out the project and home CC of the project manager.